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Comprehensive Assessment of Reform Efforts (COMPARE)

COMPARE Microsimulation Model

Overview

COMPARE is a microsimulation model that predicts the effects of health policy changes at national and state levels. The model takes a synthetic data set with information on a nationally representative sample of individuals and their employers and predicts how they will react under
different policy scenarios. Our model has been used extensively in the wake of the 2010 Patient Protection and Affordable Care Act (ACA) to estimate the effects of health reform on key outcomes, including the number of people with health coverage, the number of people who will buy
coverage through the new insurance exchanges, the number of firms that will offer coverage, and government spending. This page is intended to provide information to policymakers, researchers, and other individuals who are interested in contacting the COMPARE team or using the model to
estimate the effects of policy changes.

Featured Reports

For Arkansas, the Affordable Care Act will result in an increase in GDP of around $550 million and the creation of about 6,200 jobs. The new law will also increase health insurance coverage by 400,000 newly insured individuals.

This report examines incentives for small firms to self-insure resulting from the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA) and considers the consequences of self-insurance for health plan enrollees. The study also uses the COMPARE microsimulation model to estimate how ACA will influence decisions to self-insure.

The Affordable Care Act contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many impose additional costs on states, officials need reliable estimates of the likely impact of the ACA in their state. RAND undertook a preliminary analysis of the impact of the ACA on five states—California, Connecticut, Illinois, Montana, and Texas—using the RAND COMPARE microsimulation model.

State Reports

For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011–2020 period because of the ACA.

For Connecticut, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011–2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).

For Illinois, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Illinois will fall to 3 percent; without the law, it would remain near 15 percent. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011–2020 period because of the ACA.

For Montana, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Montana will fall to 3 percent; without the law, it would remain at 18 percent. The model projects that total state government spending on health care will be 3 percent higher for the combined 2011–2020 period because of the ACA.

For Texas, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Texas will fall to 6 percent; without the law, it would remain at 28 percent, the highest in the nation. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011–2020 period because of the ACA.

Researcher Spotlight

Senior Economist

Christine Eibner is a senior economist at the RAND Corporation and director of RAND COMPARE, a project that uses economic modeling to predict how individuals and employers will respond to major health care policy changes. She is also a professor at the Pardee RAND Graduate School.

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